Mostly older adults signing up for insurance through Washington’s exchange

Many more older adults than younger ones have rushed to sign up for health plans through the state’s online insurance exchange, early enrollment figures show.

It is one of the key findings in a report released Friday by the Washington Health Benefit Exchange, which operates the exchange, known as Washington Healthplanfinder. The report contains the first demographic breakdown of early enrollment figures for the “qualified health plans” sold through the exchange and for Medicaid, which is expanding eligibility in 2014.

Among the 6,351 people who bought qualified health plans during the first month of open enrollment, nearly 38 percent are 55 and over. Another 20 percent are ages of 45 and 54.

A little more than 5 percent of enrollees are between ages 18 and 25, and nearly 18 percent are 26 to 34.

Another 19 percent of enrollees are in the 35-to-44 age group.

These figures show that in Washington, as in other states, more older adults than younger ones have moved quickly to sign up for coverage in private plans sold through the exchange.

Medicaid enrollment figures tell a very different story.

Among the 51,379 people newly enrolled in Washington’s Medicaid program, Apple Health, the largest percentage, by far, are children under 18.

More than 13,000 children became enrolled in Medicaid in October – more than a quarter of all new Medicaid sign-ups.

In contrast, only 46 children became enrolled in qualified health plans, or less than 1 percent of the total number.

Adults ages 26 to 34 make up the second-largest group of Medicaid enrollees, at nearly 20 percent of the total.

In contrast, Medicaid enrollees age 55 and older make up about 15 percent.

Overall, the Medicaid figures show a much more even distribution among adult age groups than do the enrollment figures for qualified health plans, which skew heavily toward adults age 55 and older.

The exchange plans to intensify its outreach and enrollment efforts aimed at young adults, according to a statement released with the report.

The exchange has contracted with a national nonprofit group called the Young Invincibles to target outreach efforts to young adults, often referred to as “young invincibles” because they generally use less health care than older adults and may be less motivated to buy health insurance.

Enrolling younger adults in qualified health plans is crucial to the viability of the online insurance marketplaces because their premiums help offset the high medical costs of older, sicker adults.

In other findings, the report states that women made up 57 percent of enrollees in both qualified health plans and the expanded Medicaid program in October.

Coverage choices:

Among the more than 6,000 state residents who enrolled in private plans, nearly two-thirds chose “silver” level plans, which cover 70 percent of the costs of essential benefits.

The exchange said in its statement that the preference for silver plans is “likely due to cost-sharing subsidies, a form of financial help that lowers additional out of pocket costs such as copays and deductibles, which can only be accessed through a silver level plan under the Affordable Care Act.” These cost-sharing subsidies are separate from the tax credits that help cover the cost of monthly premiums for people who qualify.

In addition to the nearly 64 percent who enrolled in silver plans, more than 20 percent chose bronze plans, which cover 60 percent of the costs of essential health benefits, and almost 16 percent chose gold, which cover 80 percent.

Less than 1 percent enrolled in so-called “catastrophic plans” that have lower premiums but higher deductibles and cost-sharing and are generally available only to adults age 30 or younger.

Enrollment by county:

The report also breaks down enrollment by county. King County accounts for more than one quarter of all enrollments, followed by Pierce (10.9 percent), Spokane (10.2 percent) and Snohomish (8.7 percent) counties.

In Garfield County in southeast Washington, which has a population of around 2,200 people, only one person enrolled in a qualified health plan and 12 people enrolled in Medicaid, the lowest numbers of any county in the state.

About the blog

HealthCare Checkup is a new blog dedicated to helping readers understand the Affordable Care Act and how the federal health-care law affects everyone – insured or not. Reporters in Seattle, Olympia, and Washington, D.C. contribute. The editors are Beth Kaiman and Mark Watanabe.

The blog is produced through a partnership with Kaiser Health News, an editorially independent part of the Kaiser Family Foundation, a health policy research and communication organization that is not affiliated with Kaiser Permanente.